When activation changes, what else changes? the relationship between change in patient activation measure (PAM) and employees' health status and health behaviors.

OBJECTIVE

To test whether changes in the patient activation measure (PAM) are related to changes in health status and healthy behaviors.

METHODS

Data for this secondary analysis were taken from a group-randomized, controlled trial comparing a traditional health promotion program for employees with an activated consumer program and a control program. The study population included 320 employees (with and without chronic disease) from two U.S. companies: a large, integrated health care system and a national airline. Survey and biometric data were collected in Spring 2005 (baseline) and Spring 2007 (follow-up).

RESULTS

Change in PAM was associated with changes in health behaviors at every level (1-4), especially at level 4. Changes related to overall risk score and many of its components: aerobic exercise, safety, cancer risk, stress and mental health. Other changes included frequency of eating breakfast and the likelihood of knowing about health plans and how they compare.

CONCLUSION

Level 4 of patient activation is not an end-point. People are capable of continuing to make significant change within this level.

PRACTICE IMPLICATIONS

Interventions should be designed to encourage movement from lower to higher levels of activation. Even people at the most activated level improve health behaviors.